Dataset Information

Digital Application for Promoting Evidence-Based Children's Oral Health to Control Early Childhood Caries: Randomized Control Trial on Parental Acceptance and Efficacy.

ABSTRACT:

Background

Early childhood caries (ECC) remains a major global health problem. Various measures to prevent it have been implemented in the past, including those using digital applications.

Aim

To evaluate the acceptance and efficacy of a digital application (FU-APP) based on evidence-based caries control recommendations for parents of children aged 6-72 months.

Methods

Part 1, prospective questionnaire-based survey to test FU-APP (usage, acceptance, content information, usefulness, and satisfaction) filled out by parents (n = 22); Part 2, two-armed (test n = 20; control n = 23) care-based, randomized controlled trial, where the test arm received instructions verbally and via FU-APP, and the control arm received them only verbally. At baseline and follow-up (4 weeks), intraoral clinical indices (plaque index-API and caries-dmft) were recorded.

Results

FU-APP was considered by parents to be a suitable tool for gaining knowledge about oral health practices for their children (all criteria >86%). No differences in the dmft levels were expected. However, API was significantly better at the follow-up in the test-arm (p = 0.01), with no differences in the control-arm (p = 0.72).

Conclusion

A digital application can serve as an innovative tool to promote evidence-based oral hygiene recommendations among parents of children to control ECC. Its long-term usability and functionality should be tested.

SUBMITTER: Abdul Haq J

PROVIDER: S-EPMC10094947 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Digital Application for Promoting Evidence-Based Children's Oral Health to Control Early Childhood Caries: Randomized Control Trial on Parental Acceptance and Efficacy.

Abdul Haq Jameela J Splieth Christian H CH Mourad Mhd Said MS Vielhauer Annina A Abdulrahim Ruba R Khole Manasi R MR Santamaría Ruth M RM

Journal of clinical medicine 20230404 7

<h4>Background</h4>Early childhood caries (ECC) remains a major global health problem. Various measures to prevent it have been implemented in the past, including those using digital applications.<h4>Aim</h4>To evaluate the acceptance and efficacy of a digital application (FU-APP) based on evidence-based caries control recommendations for parents of children aged 6-72 months.<h4>Methods</h4>Part 1, prospective questionnaire-based survey to test FU-APP (usage, acceptance, content information, use ...[more]

PMID: 37048763

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Project description:ObjectiveIn this cross-sectional study in a large community-based sample of preschool-age children, we sought to identify distinct clusters of modifiable early childhood oral health-related behaviours (OHBs) and quantify their association with clinical and parent-reported measures of early childhood oral health.MethodsWe relied upon a questionnaire (n = 8033; 11% in Spanish) and clinical oral health data (n = 6404; early childhood caries [ECC] prevalence = 54%] collected in the context of an epidemiologic study of early childhood oral health among 3- to 5-year-old children in North Carolina. Latent class analysis was used to identify clusters of modifiable OHBs based on parents' responses to 6 questionnaire items pertaining to their children's oral hygiene, diet and dental home. The optimal number of clusters was determined based on measures of model fit and interpretability. We examined associations of OHB clusters with clinical and parent-reported child oral health status (ie, ECC prevalence, severity and proportion with untreated disease) using bivariate association tests and multivariable regression modelling with marginal effects estimation accounting for clustered data. We used Mplus v.8.6 (Muthén & Muthén, Los Angeles, CA, USA) and Stata v.16.1 (StataCorp, College Station, TX, USA) for data analyses.ResultsWe identified 2 OHB clusters, a favourable (74%) and an unfavourable (26%) one. Children in the favourable OHB cluster had better oral hygiene practices (ie, tooth brushing frequency and fluoridated toothpaste use), lower consumption frequency of sugar-containing snacks and beverages, less frequent reports of night-time bottle-feeding history and a higher likelihood of a dental home. Children in the unfavourable cluster had significantly higher ECC prevalence (57% vs 53%), caries burden (mean dmfs = 9.3 vs 7.6), untreated disease (43% vs 33%) and worse parent-reported oral health status than the favourable cluster.ConclusionsOur findings demonstrate the importance and utility of clustering common, modifiable ECC risk factors in population studies - health promotion efforts may centre on groups of people rather than individual behavioural risk factors.

Project description:Background: Parents'/guardians' perceptions of their children's oral health are useful proxies of their clinically determined caries status and are known to influence dental care-seeking behavior. In this study, we sought to examine (1) the social and behavioral correlates of fair/poor child oral health reported by guardians and (2) quantify the association of these reports with the prevalence of early childhood caries (ECC), unrestored caries lesions and toothaches. Methods: We used guardian-reported child oral health information (dichotomized as fair/poor vs. excellent/very good/good) obtained via a parent questionnaire that was completed for n = 7,965 participants (mean age = 52 months; range = 36-71 months) of a community-based, cross-sectional epidemiologic study of early childhood oral health in North Carolina between 2016 and 2019. Social, demographic, oral health-related behavioral data, and reports on children's history of toothaches (excluding teething) were collected in the same questionnaire. Unrestored ECC (i.e., caries lesions) was measured via clinical examinations in a subset of n = 6,328 children and was defined as the presence of one or more tooth surfaces with an ICDAS ≥ 3 caries lesion. Analyses relied on descriptive and bivariate methods, and multivariate modeling with average marginal effect (A.M.E.) estimation accounting for the clustered nature of the data. Estimates of association [prevalence ratios (PR) and adjusted marginal effects (AME) with 95% confidence intervals (CI)] were obtained via multilevel generalized linear models using Stata's svy function and accounting for the clustered nature of the data. Results: The prevalence of fair/poor oral health in this sample was 15%-it increased monotonically with children's age, was inversely associated with parents' educational attainment, and was higher among Hispanics (21%) and African Americans (15%) compared to non-Hispanic whites (11%). Brushing less than twice a day, not having a dental home, and frequently consuming sugar-containing snacks and beverages were significantly associated with worse reports (P < 0.0005). Children with fair/poor reported oral health were twice as likely to have unrestored caries lesions [prevalence ratio (PR) = 2.0; 95% confidence interval (CI) = 1.8-2.1] and 3.5 times as likely to have experienced toothaches [PR = 3.5; 95% CI = 3.1-3.9] compared to those with better reported oral health. Conclusions: Guardian reports of their children's oral health are valuable indicators of clinical and public health-important child oral health status. Those with fair/poor guardian-reported child oral health have distinguishing characteristics spanning socio-demographics, oral-health related practices, diet, and presence of a dental home.

Project description:BackgroundCaries burden in children disproportionately affects minority and socioeconomically disadvantaged populations. Severe early childhood caries requiring general anesthesia (GA) is a significant concern, with high caries relapse rates in subsequent years.AimTo examine associations between parental psychosocial factors, children's caries burden, and oral health-related quality of life (OHRQoL), including group differences, following a phone-based parental support intervention for children treated under GA for severe Early Childhood Caries (ECC).MethodsData were collected during a randomized controlled trial examining a phone-based parental support program. Parental stress was assessed using the Swedish Parenthood Stress Questionnaire (SPSQ), dental fear was measured with the Corah Dental Anxiety Scale (CDAS), and dental attitudes were evaluated using the Dental Beliefs Survey (DBS-R). Children's OHRQoL was assessed using the Parental-Caregivers Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS). The Total Observed Caries Experience index was used to calculate the child's cumulative caries burden. Unadjusted analyses were performed using t-tests, with effect sizes calculated as Cohen's d. A two-step path analysis examined how parental factors, intervention, and baseline caries influenced caries burden at a one-year follow-up, while also assessing caries burdens impact on children's well-being.ResultsAt the one-year follow-up, the intervention group demonstrated significantly improved OHRQoL with lower mean scores on the P-CPQ and FIS compared to the control group, indicating fewer oral health issues and less impact on family life. No statistical differences were found in parental stress, dental fears, or dental beliefs between groups. Path analysis identified baseline caries and treatment group as significant predictors of caries burden, while intervention group predicted better OHRQoL outcomes. The model explained 86.2% of caries burden variance and 12.9% of OHRQoL variance.ConclusionA phone-based parental support program significantly improved children's OHRQoL, even with a higher caries burden in the intervention group at the one-year follow-up. Parental stress, dental fears, and attitudes showed no differences and did not predict caries burden. Preventing early childhood caries in high-risk groups remains challenging, highlighting the importance of preventive initiatives that empower parents and foster collaboration with key stakeholders to reduce severe ECC. Registered at https://clinicaltrials.gov/ Identifier: NCT02487043.

Project description:OBJECTIVES:The objective of this study was to examine the association among psychological and social variables reported by American Indian parents/caregivers of preschool children and changes in their Oral Health Knowledge and Behaviors related to care of their children's teeth. We also investigated the relationship of these factors with progression of caries, as reflected by changes in their children's dmfs. METHODS:The data used for this study were collected at baseline in a clinical trial of an oral health promotion intervention comprising behavioural and clinical interventions for caries prevention delivered by tribal members on a large Southwestern American Indian reservation. Linear regression analyses were performed for changes (baseline to Year 1) in dmfs, Oral Health Knowledge and Oral Health Behavior scores, with baseline psychosocial measures, taken individually, as the independent variables. RESULTS:Parents' attitudes and beliefs were associated with increases in their Oral Health Knowledge and Behavior and also with the progression of caries for their children. When all participants were considered together, increases in children's dmfs were smaller when the caregiver had higher Internal Oral Health Locus of Control (e = -1.33, P = .004), higher Health Literacy (e = -1.55, P < .01), and higher Financial Stability (e = -4.46, P = .03), and lower scores for the Barriers subscale (e = 1.57, P < .01) of the Health Belief Model. For parents in the Intervention group, higher scores on Locus of Control, reflecting beliefs that chance, or other people determine their children's oral health, were associated with larger increases in Oral Health Knowledge (e = 1.73, P = .04) and Behaviors (e = 4.00, P = .005). CONCLUSIONS:Prevention of early childhood caries in American Indian children has proved to be especially challenging. Some of the measures identified in this report may suggest promising directions to prevention through approaches that build on competencies and skills to be learned and used within a context more broadly focused on parenting and management of health and family challenges.

Project description:BackgroundDeveloping age-appropriate medications remains a challenge in particular for the population of infants and toddlers, as they are not able to reliably self-report if they would accept and consequently take an oral medicine. Therefore, it is common to use caregivers as proxies when assessing medicine acceptance. The outcome measures used in this research field differ and most importantly lack validation, implying a persisting gap in knowledge and controversy in the field. The newly developed Caregiver-administered Children's Acceptance Tool (CareCAT) is based on a 5-point nominal scale, with descriptors of medication acceptance behavior. This cross-sectional study assessed the measurement properties of the tool with regards to the user's understanding and its intra- and inter-rater reliability.MethodsParticipating caregivers were enrolled at a primary healthcare facility where their children (median age 6 months) had been prescribed oral antibiotics. Caregivers, trained observers and the tool developer observed and scored on the CareCAT tool what behavior children exhibited when receiving the medicine (n = 104). The video-records of this process served as replicate observations (n = 69). After using the tool caregivers were asked to explain their observations and the tool descriptors in their own words. The tool's reliability was assessed by percentage agreement and Cohen's unweighted kappa coefficients of agreement for nominal scales.ResultsThe study found that caregivers using CareCAT had a satisfactory understanding of the tool's descriptors. Using its dichotomized scores the tool reliably was strong for acceptance behavior (agreement inter-rater 84-88%, kappa 0.66-0.76; intra-rater 87-89%, kappa 0.68-0.72) and completeness of medicine ingestion (agreement inter-rater 82-86%, kappa 0.59-0.67; intra-rater 85-93%, kappa 0.50-0.70).ConclusionsThe CareCAT is a low-cost, easy-to-use and reliable instrument, which is relevant to assess acceptance behavior and completeness of medicine ingestion, both of which are of significant importance for developing age-appropriate medications in infants and toddlers.

Project description:Previous research demonstrated that faster eating rates are linked with increased intake of energy during a meal. Here, we examined whether within-meal parental feeding practices show cross-sectional and prospective associations with children's oral processing behaviours and whether the previously demonstrated association between faster eating rates and higher energy intakes varies by parental feeding practices. A subset (n = 155) of children and their mothers from the Growing Up in Singapore Towards healthy Outcomes cohort participated in an ad libitum meal at age 4.5 years. Children's oral processing behaviours (eating rate, bite size, chews per gram, oral exposure time, and meal duration) and parental feeding practices (autonomy-supporting and coercive prompts, restrictions, hurrying, and slowing) were recorded during the meal. Subsequently, 94 of the children participated in a follow-up meal without their mothers at age 6 years. Parental feeding practices were not consistently associated with child oral processing behaviours overall. However, exploratory post hoc analyses revealed some sex differences. The mothers of girls with faster eating rates, larger bite sizes, and fewer chews were more likely to use hurrying, slowing, and restrictions, but similar associations were not observed among boys. Children who had the most problematic eating style and were eating fast and for long experienced more restrictions, instructions to slow down, and prompts. Faster eating rates were linked with the highest energy intakes if children were additionally prompted to eat. Prospective analyses showed that children who were more often prompted using coercive techniques and less frequently hurried at age 4.5 years had faster eating rates at 6 years and a larger increase in eating rates between ages 4.5 and 6 years but did not consume more energy. Although the direction of these associations cannot be assumed, these exploratory analyses suggest sex differences in the associations between feeding practices and oral processing behaviours and highlight the potential role of parents in the development of children's oral processing behaviours.

Dataset Information

Digital Application for Promoting Evidence-Based Children's Oral Health to Control Early Childhood Caries: Randomized Control Trial on Parental Acceptance and Efficacy.

Background

Aim

Methods

Results

Conclusion

Publications

Digital Application for Promoting Evidence-Based Children's Oral Health to Control Early Childhood Caries: Randomized Control Trial on Parental Acceptance and Efficacy.

Similar Datasets

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